May 2: New Injury Study Finds No Link to Running Form or Shoe Type

A new and not-yet-published running-injury study seems to indicate that running form and running-shoe type play little role in injury rates. Forefoot, midfoot, or rearfoot striking? POSE or Chi? Going barefoot or minimalist? All produced virtually identical injury rates. The same is true for

traditional running shoes in the three main categories: cushioning, stability, and motion-control. [See bottom of page if you would like to participate in the online study.]The study does, however, find a relationship between heel striking and knee injuries, and forefoot striking and foot, ankle, and Achilles injuries.The study was conducted at the University of North Carolina, and included more than 700 local runners who had been running an average of 10 years. The runners averaged roughly 20 miles per week. The abstract will be presented in late May at the annual meeting of the American College of Sports Medicine in Denver.Through an online survey, the runners (57% female) were asked to identify their running style, and whether they had experienced an injury in the previous 12 months.The percent of Yes answers per running style:Heel strikers (43% of sample by self report): 49.3%Midfoot strikers (32% of sample): 51%Forefoot strikers (13% of sample): 49%Barefoot runners or minimalist shoe wearers (6% of sample): 43%Chi, POSE, similar running styles (5% of sample): 46%The percent of injury per traditional running-shoe types:Stability: 52%Cushioning: 48%Motion Control: 53%"Overall the injury rates are very similar across all running styles and shoe selections," says lead author Don Goss, an Army PT studying in the biomechanics program at the University of North Carolina.Goss found that the runners reported an average of 41.6 injury days in the previous 12 months. There was no difference between those who stretched and those who did not.Washington, D.C.-area sports podiatrist Steve Pribut says he's not surprised by the results of the new study."Individual problems need individual solutions," notes Pribut. "There is no magic bullet that is right for everyone. If someone tries to sell you a device, shoe, or method of running to cure a current injury and also prevent all future injuries, the wisest thing to do is to run away."INTERVIEW WITH RESEARCHER DON GOSSRW: Why did you conduct this survey?Don Goss: I've been an Army PT conducting running shoe clinics for 16 years. We have injuries, but know so little about preventing them. I wanted to help gather more information.What have you learned from the survey?It appears that there are no differences in overall injury incidence between runners utilizing various strike patterns, different shoes or stretching methods. But if we can gather more data, and slice it thinner and thinner, we may find some interesting things below the surface. It looks like barefoot running and minimalist shoes increase risk of some foot injuries by about 1.7. While rearfoot striking and traditional shoes increase knee injuries by 1.2. So it looks like there's a "joint specificity" here, and it might turn out that certain choices are good ones for runners with particular kinds of injuries.Have you learned anything more about the barefoot and minimalist runners?Yes--that we'd like to get more to take our survey. That would increase the power of our results. So far only about 5 or 6 percent of our respondents are in these groups. At the same time, about 20 percent of respondents say they have changed their footstrike or shoes in the last several years. Fifty to 55 percent of these runners are doing it in the hope of reducing injuries, mostly knee injuries.What are the strengths and weaknesses of your study?A strength is that we're one of the first to look at this information, which is obviously of great interest to many runners now, especially those who have read Born to Run or followed the Lieberman hypothesis. The biggest weakness is that we'd like to get more runners enrolled, especially those who are taking the less-traditional path. Also, many of those have made form changes quite recently, so we'd like to get a longer history with them to see if overuse injuries increase or decrease. Of course, any time you do a self-report study, you know that some of your data isn't very accurate. We know our report of heel strikers is lower than that found in other studies.If not running form or shoes, what does cause running injuries?There's not one simple answer to that question. Training errors (e.g., too much too soon), mal-alignment or other genetic predispositions, tight soft tissues, and bad technique would certainly all be at the top of my list.TAKE THE RUNNING INJURY SURVEYYou can take the survey by clicking this link, also repeated below. Here are Don Goss's introductory comments:"Hello, I am an Army physical therapist studying running biomechanics and injuries at The University of North Carolina working with a team to conduct a survey of runners entitled, 'A Running Style Survey.'"If you run at least 6 miles per week and are between the ages 18-50, we need your help. This survey will give us valuable information concerning running injury trends and has taken others approximately 5-10 minutes to complete. You should know that there are no right or wrong answers and that your responses will be treated confidentially. Survey results will in no way be traceable to individual respondents. You can access the survey by going to the link below."http://www.surveymonkey.com/s/JGQN2F2

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